Scope
This policy applies to all WhidbeyHealth employees and professionals who are mandated reporters.
Purpose
To ensure proper identification and timely notification for victims of abuse, assault, neglect, or exploitation.
Definitions
Abuse: the willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult. In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish. (RCW 74.34.020)
Assault: the unlawful intentional touching of another person.
Neglect: means (a) a pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult; or (b) an act or omission that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult’s health, welfare, or safety (RCW 74.34.020).
Exploitation: means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another (RCW 74.34.020). Exploitation could include stealing from patients, diverting money or belongings, or taking inappropriate pictures of patients.
Vulnerable adult: (a) At least 60 years of age or older, who has the functional, mental, or physical inability to care for himself or herself; (b) found incapacitated under RCW 11.88; (c) who has a developmental disability as defined under RCW 71A.10.020; (d) admitted to the facility; (e) receiving services from home health, hospice, home care agency, individual provider or with a functional disability who live in his or her own home, who is directing and supervising a paid personal aid to perform a health care task. (WAC 388-76-10000, WAC 388-805-005)
Policy
WhidbeyHealth employees suspecting abuse will, at the earliest opportunity, contact Washington State Adult Protective Services to report their suspicions.
Procedure
ALL HEALTHCARE PROFESSIONALS ARE MANDATED TO REPORT ANY SUSPECTED ABUSE CASES.
The following list indicates those who are required to report the suspected abuse, neglect or exploitation of adults to the Department of Social Services. Anyone employed, licensed, registered or certified to provide health care services, or an employee of an agency licensed to provide Health Care Services, Hospitals referrals on protective services situations in these settings should be made to the Department of Human Services/Adult Protective Service Division at 1-877-734-6277 or online: DSHS APS Reporting
STEPS FOR AN EMPLOYEE REPORTING SUSPECTED ABUSE AT WHIDBEYHEALTH
Professional staff at WhidbeyHealth who suspects abuse, assault or neglect should implement the procedures below:
Contact Adult Protective Services at 1-800-487-0416.
Information APS may ask:
- Name/address of vulnerable adult
- Name/address of legal guardian
- Name of agency providing care
- Identify of alleged perpetrator
- Specific information regarding the abandonment, abuse, neglect, exploitation or cause of death:
– “I observed…”
– Time frame behavior has been occurring, one time vs. pattern
– Do not include clinician emotions or impressions vs. Contact law enforcement if the patient is a victim of assault or if immediate safety/wellbeing is a concern.
Documentation: Date/Time of call/summary of information provided.
Notify the manager at the first available opportunity after reports are made. A professional, who observes symptoms of abuse/neglect/exploitation or suspicion of same, is required by law to make the report or cause the report to be made. All professional medical staff are considered mandatory reporters. There is a law that protects individuals who file a report in good faith from liability. As mandated reporters, there is also a law that will charge a gross misdemeanor for not reporting suspected abuse/neglect/exploitation a child or vulnerable adult. For instances in which the suspected or alleged abuse, neglect or exploitation occurs in a facility regulated by the Department of Health, they must be notified at 800-525-0127.
The patient has a right to be protected from abuse and neglect and have access to protective services.
The following criteria for identifying possible abuse and neglect include, but are not limited to the following “RED FLAGS”
BEHAVIORAL AND PHYSICAL INDICATORS/CRITERIA FOR THE IDENTIFICATION OF POTENTIAL ABUSE/NEGLECT OF AN ELDERLY OR VUNERABLE ADULT
ABUSE OR NEGLECT: Discrepancies between history and injury; Inconsistencies in the history
PHYSICAL ASSAULT (ABUSE): Unusual or unexplained bruising; Fractures; Burns; Repeated Injuries; Head injuries
RAPE/SEXUAL MOLESTATION: Bleeding, bruising or trauma to genitalia; History of sexual assaults as reported by patient; Repeated UTI unrelated to other causes; Pregnancy or Sexually transmitted diseases; Sexual knowledge that exceeds the level of maturity; Abnormal mental status
EMOTIONAL OR PSYCHOLOGICAL ABUSE: Withdrawn or excessively aggressive behavior; Inappropriate caregiver/adult interaction; Depression; Conduct disorder; Suicidality
NEGLECT OF ELDERS OR VUNERABLE ADULTS: Lack of personal hygiene and/or appropriate clothing; Malnourished/dehydrated; Lack or delay in medical care; Over/under medicated; Lack of heat and/or running water
DOMESTIC ABUSE Unusual or unexplained bruising; Fractures; Burns; Repeated injuries; Head/Face injuries; Non-substantiated complaints and/or delays in obtaining care; Third-party or object blames for injury; Alleged self-injury
FINANCIAL EXPLOITATION Improper or illegal use or management of an elderly or disabled adult’s funds, assets or property; Use of an elderly or disabled adult’s power of attorney or guardianship for one’s own profit or advantage.
When You Must Also Call:
Law Enforcement
Mandatory reporters must also make a report to law enforcement if they suspect a vulnerable adult has been sexually or physically assaulted, or if they have reasonable cause to believe that an act has caused fear of imminent harm.
Mandatory reporters may not have to make a report to law enforcement for some types of physical assault between two vulnerable adults. For these types of physical assault, see RCW 74.34.035(4).
Medical Examiner or Coroner
Mandatory reporters are also required by law to report a death to the local Medical Examiner or Coroner if there is reason to suspect that the death of a vulnerable adult was caused by abuse.